FAQ

How is Anti-Aging Medicine (AAM) different from geriatrics?

AAM is actually the opposite of geriatrics. While geriatrics tries to make the diseases and losses of aging more tolerable by treating the symptoms, AAM seeks to prevent, reverse and manage the process of aging.

 

Are all physicians and allied health practitioners qualified to practice AAM?

No. We believe you deserve MD's who are dedicated to AAM and who practice this specialty exclusively and are on the cutting edge of AAM treatment and research. We believe you deserve physicians that have been recognized for their expertise in this rapidly advancing field by board examination.

 

Is this 'alternative medicine'?

The MD's at CHI integrate the most effective therapies from traditional medicine and holistic medicine. We have analyzed the data that is available on all methods of treatment and present our patients with the best of both worlds. While taking advantage of the latest data and innovations we insist on cautious and responsible practices that are backed up by published data.

 

Why should I begin my anti-aging program today. Why not wait for the advances that will come in future years?

There will be dramatic gains in our knowledge of this field over the next decade. We wish to manage and control aging as much as possible right now so you will be able to benefit from the new advances with the best possible functioning mind and body.

 

Can't I plan my own AAM program by following a good diet, exercising, taking vitamins and reading articles.

No. To be most effective you need your program supervised by a physician (MD) who can prescribe the most effective diet plan, exercise regime, supplements and herbal prescription medicines that have documented anti-aging effects.

 

Can't I take "secretagogues" that contain amino acids to boost my hormone levels instead of natural hormone replacement? 

Amino acids may modestly increase biomarker levels of growth hormone but what is usually required is at least a 100% increase. Most patients will not have significant gains with these products. Two of the most powerful stimulants for growth hormone release are resistance exercise and a good night's sleep. However, as you age the hypothalamus becomes resistant to these powerful stimulants and so it is very unlikely that secretagoges which are weaker stimulants would be effective. 

 

What about multilevel marketing products such as sublingual sprays that claim to contain human growth hormone?

Human growth hormone is a prescription medicine. Therefore sprays that advertise that they contain human growth hormone would be legal only if they contained an infinitesimal amount that would not be physiologically active.

 

If my testosterone levels are low can't I use testosterone precursors such as androstenedione?

Androsteinedione is metabolized to testosterone producing a short spike 2 hours later. The enzyme that converts androstenedione to testosterone is the rate limiting step and cannot produce adequate levels of testosterone in males greater than 45 years. Natural testosterone (the identical molecule which exists in the human male and female) can be replaced by transdermal skin creams or injectable testosterone uypionate to achieve the precise testosterone level that is optimal for libido, muscle strength, sense of well being and prevention of disease under the guidance of an anti-aging physician who monitors blood levels. We have found this to be the most effective treatment.

 

Will my "health insurance" cover the expenses of my AAM program?

No. Health insurance is actually disease insurance and will not cover this form of preventive medicine. In a way, it a good thing. We are able to focus our program entirely on you without considerations of third parties. We are able to maintain complete confidentiality and are not constrained by limits set to maximize insurance company profits. We are working for you, not them.

 

Is "hormone replacement therapy" in women safe?

The Women's Health Initiative study show that traditional HRT with Premarin (made form pregnant mares urine) and Provera a chemically synthesized artificial progesterone) is not safe. Bio-Identical hormone therapy with natural Estrogens and Progesterone is safe and does not have to adverse side effects of Premarin and Provera. Provera can increase the rate of breast cancer but natural Progesterone can decrease the rate 10%

Fournier A et al. Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort. Int J Cancer. 2005 Apr 10;114(3):448-54.

There is no increase in risk of cancer or heart disease. There is typically weight loss and improved well being and quality of life.

de Lignieres B et al. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women. Climacteric. 2002 Dec;5(4):332-40.

 

What about women and testosterone? Isn't that a male hormone?

Testosterone is the third female hormone. Women need lower doses than men. Restoring testosterone in women increases libido, strength and muscle, bone density and well being.

 

What data is there in the medical literature that Anti-aging medicine is safe and effective?

Rudman, D et al. Effects of Human Growth Hormone in Men over 60 years old. New England Journal of Medicine. 323:1-6, 1990.

Dr. Rudman's article in the prestigious New England Journal of Medicine concluded that Human Growth Hormone replacement therapy reversed the changes of aging 10-20 years.

Cittadini A et al. American Journal of Physiology 1994 Aug;267(2 Pt 1):E219-25

Impaired cardiac performance in GH-deficient adults and its improvement after GH replacement. 

Part of the weakness and eventual debility that is associated with growth hormone deficiency is poor cardiac function. Replacing growth hormone will improve heart function.

 O'Halloran DJ, Tsatsoulis A, Whitehouse RW et al. Increased Bone Density after Growth Hormone (HGH) Therapy in Adults with Isolated HGH Deficiency. J Clin Endo Metab 1993;76:1344-48.

Growth hormone replacement is the only known treatment which will actually cause new bone growth, decreasing osteoporosis and the risk of fracture. 

Salomon F, Cuneo RC, Hesp R et al. The Effects of Treatment with Recombinant Human Growth Hormone on Body Composition and Metabolism in Adults with Growth Hormone Deficiency. New England Journal of Medicine 1989;321:1797-1803.

Bengtsson BA. The Consequences of Growth Hormone Deficiency in Adults. Acta Endocrinologica 1993;128 (Suppl 2):2-5.

Cuneo RC, Salomon F, Wiles CM et al. Growth Hormone Treatment in Growth Hormone Deficient Adults. II. Effects on Exercise Performance. Journal of Applied Physiology 1991;70:695-700.

O'Halloran DJ, Tsatsoulis A, Whitehouse RW et al. Increased Bone Density after Recombinant Human Growth Hormone (GH) Therapy in Adults with Isolated GH Deficiency. Journal of Clinical Endocrinology and Metabolism 1993;76:1344-1348.

McGauley GA, Cuneo RC, Salomon F et al. Psychological Well-Being Before and After Growth Hormone Treatment in Adults with Growth Hormone Deficiency. Hormone Research 1990;33 (suppl 4):52-54.

Bengtsson BA, Eden S, Lonn L et al. Treatment of Adults with Growth Hormone (GH) Deficiency with Recombinant Human GH. Journal of Clinical Endocrinology and Metabolism 1993;76;309-317.

Johnston DG, Bengtsson BA. Workshop Report: the Effects of Growth Hormone and Growth Hormone Deficiency on Lipids and the Cardiovascular System. Acta Endocrinologica 1993;128 (Suppl 2): 69-70.

Amato G, Carella C, Fazio S et al. Body Composition, Bone Metabolism, and Heart Structure and Function in Growth Hormone (GH)-Deficient Adults Before and After GH Replacement Therapy at Low Doses. Journal of Clinical Endocrinology and Metabolism 1993;77:1671-1676.

 Lieberman SA, Hoffman AR. Clin Geriatr Med 1997 Nov;13(4):671-84. The somatopause: should growth hormone deficiency in older people Be treated?

Rosen T, Johannsson G, Johansson JO, Bengtsson BA . Horm Res 1995;43(1-3):93-9.Consequences of growth hormone deficiency in adults and the benefits and risks of recombinant human growth hormone treatment. A review paper.

Replacement therapy with grown hormone is safe without any serious side effects

 Johannsson G, Rosen T, Bosaeus I, Sjostrom L, Bengtsson BA. J Clin Endocrinol Metab 1996 Aug;81(8):2865-73. Two years of growth hormone (GH) treatment increases bone mineral content and density in hypopituitary patients with adult-onset GH deficiency.

In 2 years of treatment with growth hormone, bone density increases 4%

There is a mountain of evidence of the benefits of growth hormone replacement to youthful levels. There is approximately 20 year experience in children receiving growth hormone that demonstrates that no serious medical complications are seen.

Are there other Internet sites you can recommend?

Yes.  You may want to visit Dr. Nigro's Reconstructive Surgery web site. http://www.drnigro.com